(199) - Trait perceived injustice is associated with pain outcomes in healthy participants undergoing an experimental pain induction procedure: scale development and validation

Abstract

Perceived injustice has been conceptualized as an appraisal process reflecting the severity and irreparability of pain-related loss, blame, and unfairness. Extant research indicates that perceived injustice is associated with greater pain severity, pain behavior, depressive symptoms, and anger in individuals with pain-related conditions. Research conducted to date has proceeded from the assumption that perceptions of injustice emerge as a result of injury that leads to pain and disability. However, it is possible that individuals who react to their injury with a high level of perceived injustice and may have a propensity to interpret all adverse life experiences in terms of unfairness. To date no research has examined whether perceived injustice may have trait-like characteristics. The aim of the present research was to develop and validate a measure of trait perceived injustice (T-IEQ) in healthy individuals undergoing a cold water immersion task. The study sample consisted of 118 healthy adults. Participants completed measures of T-IEQ, and beliefs in a just world before the cold water immersion. During the immersion, participants rated their pain, and their emotional responses in terms of anger, sadness and worry. Consenting participants were also videotaped during the cold water immersion. Participants came back to complete the trait injustice measure at one month follow-up. The T-IEQ had high internal consistency and test-retest reliability. Individuals who scored high on a T-IEQ also exhibited more pain behavior, and reported higher ratings of pain intensity, anger and sadness during cold water immersion. T-IEQ was negatively correlated with measures of beliefs in a just world. It was also found that anger mediated the relation between T-IEQ and pain outcomes. This study demonstrated that perceived injustice can be construed as a dispositional characteristic that is associated with increased pain intensity and pain behaviour. Theoretical and clinical implications are discussed.